Maya and Jay's wedding in Sarasota, Florida, USA. Saturday 25th April 2015 when I began receiving texts from Australia and Nepal regarding a severe earthquake with extensive damage. Maya is a founder of Spiral Health International (SHI).
"Thank You for helping Nepal"
"US sends transport super planes (C-17)"
"More choppers needed in Nepal"
Arrival at Tribhuwan International Airport (KTM) on Thai Airways with USAF C-17's nearby.
Greetings from Ram Krishna Pokharel of Icefall Adventures and Icefall Productions. An Everest beer at Yak and Yeti Hotel.
The devastation……………..
…………….. is wild spread.
Arrival at Grande International Hospital…….
…….. Which survived the earthquake and aftershocks with modest structural damage.
The team gets ready for work.
Left to Right i. Bigyan Bhandari MD
ii. Ram Krishna Pokharel
iii. Binod Bijukachhe MD
iv. "Dr. Chet"
v. Prashant Adhikari MD
Case Example: young woman sustained traumatic injury to cervical spine when struck by collapsing building. AP xray shows right collapsing building mechanism of injury to lower c-spine.
Lateral x-ray shows additional flexion force applied to the c-spine with discoligamentons injury C4-7.
MRI confirms cord compression and cervical kyphosis C4-7. Patient has minor incomplete spiral cord injury (SCI).
"Dr. Binod" prepares the patient for an anterior approach.
ACDF (Anterior Cervical Discectomy and Fusion) implants and instruments donated to SHI by….
.......NuVasive of San Diego, California, USA for Nepal Earthquake Disaster Relief Effort.
Intraperative lateral fluoroscopic view shows discectomies C4-7 with decompression of spinal cord, PEEK interbody devices (IBD)'s and anterior plate fixation C4-7 with restoration of cervical lordosis.
Intraoperative photo.
::Nepal Earthquake- Photo Comments
Dr. Bijukachhe evaluates patient after surgery.
Neurologically intact and improved neck pain.
Grande International Hospital (GIH) aids disaster relief efforts.
GIH notices.
GIH notice to American victims.
Notice to British victims.
The new National Trauma Centre (NTC) was dedicated in November 2014, but had not yet opened its doors when the 7.9 magnitude earthquake struck Nepal on 25th April 2015.
However, the new NTC admitted patients urgently utilizing staff from nearby Bir Hospital, the oldest hospital in Kathmandu.
The wards were flooded with earthquake victims and their families.
Dr. Giri and Dr. Chet plan a surgery.
Our patient is first on the list.
36 years old male earthquake victim from building collapse. Patient has complete spinal cord injury (SCI) classified ASIA A by the American Spinal Injury Association Classification. Lateral x-ray reveals compression flexion fracture of L1 with unstable dislocation T12-L1.
AP x-ray reveals compression fracture of L1 vertebra with widened pedicles implying concomitant lamina fracture.
MRI demonstrates transaction of spinal cord by central translation of T12 on L1
The team gently transfers the patient to the OR table.
Successful reductions of the T12 & L1 fracture dislocation and stabilization with pedicle screw fixation and supplemental wire tension band.
A satisfied orthopedic team
Bir Hospital, the oldest in Kathmandu, next door to the new NTC.
Broken bones and legs in traction can't keep this Nepali boys smile away!
On 12th May 2015, the second major earthquake strikes with 7.2 magnitudes. I have just photographed my liquid refreshment. The quake interrupted the meal but the Gorkha beer was saved!
(Video-1418 thamel after 2nd earthquake)
And the Gorkha beer was finished!!!
Florida Gator out of the Swamp and into the disaster tone………………..
As the hospitals are flooded with a new wave of trauma victims, the operating theaters are ptoiritized for urgent crush injuries to head, chest, abdomen, and extremities. Spine surgeries are cancelled and delayed. NBC film crew from USA redeployed to document triage efforts and further devastation to buildings and monuments.
Bhaktapur, a world heritage site near Kathmandu sustains further destruction and traumatic injuries to earthquake victims.
Damage to Bhaktapur is extensive.
Emergency teams search for survivors in Kathmandu.
NBC reporter, Katy Tur, arrives from London to cover the tragedy.
American Katy Tur in Kathmandu.
Our next patient injured in building collapse.
Dr. Giri prepared the OR in NTC.
Lateral x-ray shows compression-flexion injury to thoracic vertebra with fracture-dislocation at T7-8.
AP x-ray confirms fracture at T8 with no widening of pedicles indicating intact lamina.
SCI is incomplete.
Dr. Giri receives gift from SHI and Nu Vasive Spine Foundation……. a pedicle probe.
The OR nursing team appreciates the assistance given by SHI and Nu Vasive.
A dichotomy…. a beautiful day in May with blue skies and Lavender Jacaranda trees in bloom. But the Nepalese military grounds are filled the displaced Nepalis in tents donated by China whilst the drama of injury and surgery plays out of the NTC in the background.
The new NTC(National Trauma Centre)
The time has come to return to USA. Thanks to Binod and Sabina Bukachhe MDs (Orthopedic Spine and Ophthalmology) for providing lodging for me at their home.
Thanks to Ram Krishna Pokharel, his wife Shova, and their daughter Ashora for providing all logistics and planning during the SHI effort in Nepal.
And thank you to the Nu Vasive Spine Foundation for their generous donation of cervical and thoracolumbar implants and instruments on very short notice. The people of Nepal are grateful. Om Mane Padme Hum.
